NURS 5333 - PCOS: Primary Care Challenge: Questions
And Detailed Answers
Polycystic Ovarian Syndrome Correct Answer - Ask about their birth
experience.
Where they ever fed high calorie formula as infants
Genetic link, runs in family.
Polycystic Ovarian Syndrome (PCOS) Correct Answer - Noted syndrome
of androgen excess and infertility.
some pt's may not all have ovarian cyst
Diagnostic Criteria Correct Answer - -Irregular or no menstrual periods
in women of reproductive age (ovulatory dysfunction)
-Acne
-Weight gain (overweight, obesity)
-Excess hair growth on the face and body (hirsutism)
-Thinning scalp hair from excess testosterone
-Ovarian Cysts (Polycystic ovarian morphology)
-Mental health problems (depression, anxiety)
Dangerous Correct Answer - -PCOS can end up infertility
-Gestational Diabetes
-DM Type 2
-CAD, hyperlipidemia, HTN
-Sleep Apnea
-Endometrial Cancer due to not having periods, lining thickens
-Body image disturbance, depression, social anxiety
Signs and Symptoms Correct Answer - -Menstrual irregularity : ask pt if
they have ever had regular periods before
-Androgen excess: acne and hirsutism (ask if they did something to control
excess hair)
-Always identify the onset of symptoms
-PCOS has a slow onset, virilizing tumor typically causes rapid onset of
hirsutism and acne
, Acanthosis Nigricans Correct Answer - -Excess insulin causes skin cell in
certain areas to turn over more rapidly
-these cells contain more melanin and produce darker patches
-Patients with darker skin may produce more noticeable patches
Alopecia Correct Answer - -Generalized hair loss, all the hair is falling off
-Caused by elevation of testosterone precursors
-Hair loss is greater than 100 hairs per day is common
Hirsutism Correct Answer - -Due to Androgens
-Hair removal needed
-Vaniqua cream
eflornithine hydrochloride)
6-9 months change
Inhibits cell division need from hair growth
-Adjunct to hormonal therapy
How not to get confused... Correct Answer - First think about
- Hirsutism
- acne
- menstrual abnormality
Does my pt have these 3 things?
Then ask, did this come on quickly or slowly?
THEN..
Set up to start ordering labs and measure testosterone levels
PCOS labs : Testosterone Correct Answer - Prefer to order Free
testosterone level instead of Total testosterone (avoid)
PCOS level typically range from 2-150
If over 200, suspect a virilizing tumor
Draw before starting any type of hormonal meds
If pt has signs of PCOS and normal testosterone, REDRAW test at 8 AM (best
time to draw the free testosterone level)
DHEA-S precurser Correct Answer - -Coming from adrenal glands
-Helps detect adrenal hyperadrogenism
-Very very elevated. Commonly elevated in PCOS
-Levels above 700 suggest Adrenal Tumor
And Detailed Answers
Polycystic Ovarian Syndrome Correct Answer - Ask about their birth
experience.
Where they ever fed high calorie formula as infants
Genetic link, runs in family.
Polycystic Ovarian Syndrome (PCOS) Correct Answer - Noted syndrome
of androgen excess and infertility.
some pt's may not all have ovarian cyst
Diagnostic Criteria Correct Answer - -Irregular or no menstrual periods
in women of reproductive age (ovulatory dysfunction)
-Acne
-Weight gain (overweight, obesity)
-Excess hair growth on the face and body (hirsutism)
-Thinning scalp hair from excess testosterone
-Ovarian Cysts (Polycystic ovarian morphology)
-Mental health problems (depression, anxiety)
Dangerous Correct Answer - -PCOS can end up infertility
-Gestational Diabetes
-DM Type 2
-CAD, hyperlipidemia, HTN
-Sleep Apnea
-Endometrial Cancer due to not having periods, lining thickens
-Body image disturbance, depression, social anxiety
Signs and Symptoms Correct Answer - -Menstrual irregularity : ask pt if
they have ever had regular periods before
-Androgen excess: acne and hirsutism (ask if they did something to control
excess hair)
-Always identify the onset of symptoms
-PCOS has a slow onset, virilizing tumor typically causes rapid onset of
hirsutism and acne
, Acanthosis Nigricans Correct Answer - -Excess insulin causes skin cell in
certain areas to turn over more rapidly
-these cells contain more melanin and produce darker patches
-Patients with darker skin may produce more noticeable patches
Alopecia Correct Answer - -Generalized hair loss, all the hair is falling off
-Caused by elevation of testosterone precursors
-Hair loss is greater than 100 hairs per day is common
Hirsutism Correct Answer - -Due to Androgens
-Hair removal needed
-Vaniqua cream
eflornithine hydrochloride)
6-9 months change
Inhibits cell division need from hair growth
-Adjunct to hormonal therapy
How not to get confused... Correct Answer - First think about
- Hirsutism
- acne
- menstrual abnormality
Does my pt have these 3 things?
Then ask, did this come on quickly or slowly?
THEN..
Set up to start ordering labs and measure testosterone levels
PCOS labs : Testosterone Correct Answer - Prefer to order Free
testosterone level instead of Total testosterone (avoid)
PCOS level typically range from 2-150
If over 200, suspect a virilizing tumor
Draw before starting any type of hormonal meds
If pt has signs of PCOS and normal testosterone, REDRAW test at 8 AM (best
time to draw the free testosterone level)
DHEA-S precurser Correct Answer - -Coming from adrenal glands
-Helps detect adrenal hyperadrogenism
-Very very elevated. Commonly elevated in PCOS
-Levels above 700 suggest Adrenal Tumor
